Insurance Coverage and Treatment Use Under the Affordable Care Act Among Adults With Mental and Substance Use Disorders

“…These findings are consistent with other research suggesting that Medicaid expansion increases eligibility for those with mental illness (Saloner et al., 2017). The results also indirectly support prior evidence suggesting an association between low‐income status and mental illness (Adler et al., 2016; Golberstein, 2015; Patel et al., 2018).…”

“…Our findings contribute to the emerging literature on the impact of the ACA (Gonzales et al 2016; Saloner et al 2017), whose findings suggest that access to health insurance and utilization of services has increased (Wherry and Miller 2016), health care related financial burdens have decreased (Ali et al 2016b), and barriers to paying for health services have been reduced (Chen et al 2016). Our findings are consistent with this, in that we found that adults with SPD were more likely to have health insurance coverage and experience lower barriers in accessing treatments after 2014.…”

“…However, despite large gains in health insurance coverage, there was no change in the proportions receiving any mental health treatment or reporting unmet mental health needs. This is in contrast to the general population, where implementation of the ACA was associated with an increase in mental health treatment, a finding also demonstrated in this study (19,20,30). When taken together with previous work indicating that the ACA is not associated with changes in substance use treatment for individuals with criminal justice involvement, we conclude that behavioral health treatment for individuals with criminal justice involvement did not increase after ACA implementation (31).…”